| Risk Factors
Peripheral artery disease (PAD) is disease of any blood vessel that is not part of the heart or brain. PAD is caused by deposits of fatty material in arteries of the legs. Since arteries carry oxygen-rich blood to the cells of the body, a reduction in blood flow can cause organ failure.
PAD is usually caused by a gradual buildup of plaque called
that happens within the arteries. Other causes include blood clots or embolisms, congenital heart disease, and inflammation of the blood vessels called vasculitis.
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PAD can be hereditary. You also may get PAD if you are overweight or
obese, or have
high cholesterol. Unhealthy lifestyle choices such as smoking, eating a high-fat diet, and not getting enough exercise lead to PAD.
PAD is more common in men and in people over 50 years of age. Other factors that increase your chance of developing PAD include:
- Family history of PAD
High blood pressure
or family history of high blood pressure
or family history of stroke
or family history of high cholesterol
Symptoms of PAD are related to the organ or part of the body deprived of blood. This includes:
- Pain, fatigue, aching, tightness, weakness, cramping or tingling in the leg(s) brought on by exercise that goes away when resting
- Numbness and pain of the legs or feet at rest
- Cold hands, legs, or feet
- Loss of hair on the legs and/or feet
- Paleness or blueness of the legs
- Weak or absent pulse in the leg
- Sores, ulcer, or infection of the feet and legs that heal slowly
- Erectile dysfunction
- Swelling in lower extremities
- Muscle atrophy
You will be asked about your symptoms and medical history. A
will be done.
During the exam, your doctor may:
- Check the strength of the pulse in the leg arteries
- Listen for a whooshing sound in a leg artery or the abdomen using a stethoscope
- Check blood pressure at various points in the leg and compare it to the normal arm blood pressure
- Conduct a treadmill test
Your bodily fluids may be tested. This can be done with blood tests.
Images help evaluate blood vessels and surrounding structures. This can be done with:
Your heart activity may need to be tested. This can be done with an
Early treatment can slow or stop the disease. Talk with your doctor about the best treatment plan for you. Treatment options include the following:
- Blood pressure
Increased physical activity—such as a walking program
- Weight loss, if overweight
Low-saturated fat, low-cholesterol
- Foot care
—very important for people with diabetes:
- Shoes that fit properly
- Proper treatment of all foot injuries—healing is slowed when circulation is poor, so the risk of infection is higher
The following medications may be prescribed:
- Blood thinners to reduce blood clots
- Pain medication
to lower cholesterol
- Vasodilators to widen arteries
Procedures may include:
—a balloon is inflated in the artery to stretch it
implant—a wire mesh tube is placed in the artery; the stent expands and stays in place, keeping the artery open
- Laser treatment
—a tube called a catheter is used to remove plaque inside a blood vessel
Surgery to open up narrowed arteries is performed in severe cases:
—the lining of the artery is removed, along with plaque build up
- Bypass surgery—a vein from another part of the body or a synthetic graft replaces the vessel
General guidelines to prevent PAD include lifestyle changes, smoking cessation, and adhering to any treatment plans for other health conditions.
About peripheral artery disease (PAD). American Heart Association website. Available at:
http://www.heart.org/HEARTORG/Conditions/More/PeripheralArteryDisease/About-Peripheral-Artery-Disease-PAD_UCM_301301_Article.jsp. Updated September 15, 2014. Accessed March 2, 2016.
American College of Cardiology and American Heart Association 2005 Practice Guidelines for the management of patients with peripheral arterial disease.
Gey DC, Lesho EP, Manngold J. Management of Peripheral Arterial Disease.
Am Fam Physician. 2004;69:525-532.
Lumsden AB, Rice TW. Medical management of peripheral arterial disease: a therapeutic algorithm.
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Mahmud E, Cavendish JJ, Salami A. Current treatment of peripheral arterial disease: role of percutaneous interventional therapies.
J Am Coll Cardiol.
Peripheral arterial disease.
Am Fam Physician. 2004 Feb 1;69(3):533. Available at:
http://www.aafp.org/afp/2004/0201/p533.html. Accessed March 2, 2016.
Peripheral arterial disease and claudication. American Academy of Family Physicians Family Doctor website. Available at:
http://familydoctor.org/familydoctor/en/diseases-conditions/peripheral-arterial-disease-and-claudication.html. Updated April 2014. Accessed March 2, 2016.
Peripheral arterial disease (PAD) of lower extremities. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114200/Peripheral-arterial-disease-PAD-of-lower-extremities. Updated August 11, 2016. Accessed September 23, 2016.
Regensteiner JG, Stewart KJ. Established and evolving medical therapies for claudication in patients with peripheral arterial disease.
Nat Clin Pract Cardiovasc Med. 2006;3: 604-610.
11/18/2011 DynaMed's Systematic Literature Surveillance
http://www.dynamed.com/topics/dmp~AN~T114200/Peripheral-arterial-disease-PAD-of-lower-extremities: Rooke TW, Hirsch AT, Misra S, et al. 2011 ACCF/AHA focused update of the guideline for the management of patients with peripheral artery disease (updating the 2005 guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011;124(18):2020-2045.
Last reviewed March 2017 by
EBSCO Medical Review Board
Michael J. Fucci, DO, FACC
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